Aura: Warning Sign Of A Migraineand A Future Stroke
Excruciating pain. Nausea. Sensitivity to light. The crushing symptoms of migraine headaches affect 15% of the population and, unfortunately, women are 3 times as likely as men to experience them.
Migraine headaches alone are bad enough. But add the symptoms related to auras and your risk of a future stroke goes up significantly.
A migraine headache with aura, known as a classical migraine, affects up to 30% of migraine sufferers. Five to 20 minutes before the onset of the headache, you see flashing lights, sparks, and dark patches. These effects might be accompanied by the feeling of pins and needles, spreading from one part of your body to another.
In some ways the aura is a good thing. Longtime sufferers recognize the aura as a warning sign of an oncoming migraine. It allows the victim to prepare, taking medication to reduce the severity of the migraine.
The migraine with aura should also be seen as a warning sign of possible stroke and heart problems.
WHAT IS THE RISK?
First, the good news: In most people, migraines rarely result in a stroke. Evidence says its also unlikely that a stroke will occur during a migraine.
The not-so-good news: People who suffer migraines are more likely to eventually have some type of heart or vascular problem. A cause-and-effect hasnt been proven. In other words, the migraine with aura doesnt CAUSE the stroke. But the two do occur together.
WHAT YOU CAN DO
What Is Migraine Aura Without Pain
Migraine aura without pain includes changes in vision or changes in the other senses and speech but no head pain. Symptoms gradually build over 5 to 20 minutes and then go away after about 1 hour. The lack of head pain sets it apart from other types of migraine with aura. Also, no other disorder can be found to be blamed for the symptoms.1
When Should I Seek Immediate Help Or Contact My Healthcare Provider
- You are experiencing the worst headache of my life.
- You are having neurologic symptoms that youve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
- Your headache comes on suddenly.
- You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
- The number or severity of your headaches increase or your headache pattern changes.
- Your medications no longer seem to be working or youre experiencing new or different side effects.
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A Richer View Of Aura
Drawings of the strange visual phenomena seen by people who experience auras are helping scientists to understand the condition.Credit: Priya Rama
In 2012, neurologist Andrew Charles received a phone call from a septuagenarian engineer who had begun having migraines with aura at the age of 14. The man, who asked to be identified as P.V., told Charles that for the previous 18 years he had been drawing every single aura he had experienced an average of 80 per year.
Whenever he sensed an aura beginning, P.V. grabbed a sheet of paper and sketched what he saw. With an engineers meticulousness, he ran a stopwatch and redrew the shifting mirage every minute until it ended, typically 2530 minutes later. He asked Charles whether his drawings might be useful to scientists interested in migraine. Soon after, P.V. arrived in Charless office at the David Geffen School of Medicine at the University of California, Los Angeles, and deposited a thousand-strong stack of papers on the desk.
P.V.s auras began as a small focal disturbance, which then expanded into a slowly spreading, crescent-like shape. The leading edge of this crescent was a flickering, morphing band of zigzagging, multicoloured lines known as a fortification spectrum. In the spectrums wake was an area of diminished vision called a scotoma.
Lifestyle Changes And Home Remedies
Home remedies may help alleviate some migraine symptoms, while lifestyle changes can prevent onset.
To treat a migraine using home remedies:
- Take a nap when symptoms first appear.
- Lie down in a quiet, cool, dark room.
- Place a cool compress or ice pack on the forehead or back of the neck.
Lifestyle changes that may help prevent migraine episodes include:
- practicing stress reduction techniques, including yoga, deep breathing exercises, and progressive muscle relaxation exercises
- sticking to a consistent sleep routine, with the same bedtime and wake time every day
- eating a balanced diet that is low in processed foods and food additives
- drinking plenty of water and limiting or avoiding caffeine and alcohol
- avoiding migraine triggers, where possible, or using preventative medicines before triggering events
For severe or recurrent migraine episodes, it is usually most effective to use medical treatments alongside home care strategies.
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Headaches Are Usually Relegated To The Head
Dr. Williams acknowledged that basic headaches are noxious, telling me, A headache is an unpleasant sensation in any region of the head or upper neck. It may appear as a dull ache, a throbbing feeling or a sharp pain, and intensities of the pain vary with whatever is causing it, he said. Though most people associate a headache with pain in the brain, the actual pain felt is stemming from the tissues that surround the brain. A headache can be brief lasting less than an hour or linger for several days.
But heres the essential takeaway regular headache pain is localized. There arent additional symptoms in other parts of the body, as is the case with migraines.
What Triggers Migraine With Aura
What exactly causes an aura is unknown. It is believed to be caused by a wave of electrical activity spreading across the brainâs cortex.
This wave is then followed by prolonged suppression of nerve cell activity. This can lead to various changes, such as changes in blood flow, that can lead to migraine symptoms.
Itâs also possible that the aura is triggered by the same things that can trigger migraine attacks without aura. These are:
-Migraine attacks can be triggered by various factors. Common triggers include:
Emotional stress is one of the most common triggers of migraine headaches. During stressful events, certain chemicals in the brain are released to combat the situation.
The release of these chemicals can trigger migraines. Other emotions such as anxiety, worry, and excitement can increase muscle tension and dilate blood vessels. This can make migraines more severe.
skip a meal
Delaying a meal can also trigger migraine pain.
Sensitivity to certain chemicals and preservatives in foods
Certain foods and beverages, such as aged cheese, alcoholic beverages, food additives such as chocolate and nitrates, and fermented or pickled foods are responsible for triggering up to 30% of migraines.
Too much kafein Taking or avoiding caffeine can cause a headache when the caffeine level drops suddenly.;
Daily use of pain medication
If you use medications used to relieve headaches too often, this can cause a rebound headache.
Hormonal changes in women
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How To Prevent Migraines With Aura
A majority of migraine patients report having triggers that precede the onset of a migraine attack. This means that knowing which migraine triggers;lead to attacks has the potential to help prevent migraines with aura. One of the best ways to identify and avoid triggers that are specific to your experience is by using a migraine diary: a running journal of attacks, symptoms, pre-headache symptoms, severity, and more.
Some of the most common triggers include:
- Too much or too little sleep
- Skipping Meals
How Are Migraines Diagnosed
To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your familys, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:
- Describe your headache symptoms. How severe are they?
- Remember when you get them. During your period, for example?
- Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
- Remember if anything makes your headache better or worse.
- Tell how often you get migraine headaches.
- Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
- Discuss what medications you take to relieve the pain and how often you take them.
- Tell how you felt before, during and after the headache.
- Remember if anyone in your family gets migraine headaches.
Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.
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What Causes Migraines In Males
While migraine tends to be more prevalent in women, it also affects an estimated 6-9% of men, many of whom inherit the condition from their parents. Additionally, headaches that resemble migraine are also common among athletes and military personnel following their exposure to repeated head traumas with and without loss of consciousness. These migraine-like headaches are called post-traumatic headache.
Athletes with concussions sustained during contact sports show greater incidence of migraine symptoms. In fact, a 2005 study found that concussed athletes demonstrated significantly greater migraine symptoms. This risk tends to disproportionately affect men, as shown in a 2014 survey of 37 countries that found men across the globe were more likely to play competitive sports than women.
Also, research has shown that men in the military are disproportionately likely to suffer from migraines due to PTSD. In one study, out of 2,200 returning male soldiers, 19 percent suffered from migraines.
Now that weve explored some potential underlying causes, well examine pre-migraine symptoms that typically warn migraineurs of an oncoming attack.
Enabling Blood Flow To The Brain
The cervical vertebrae contain openings called vertebral foramen. These passageways provide a place for the vertebral arteries that provide the brains blood and oxygen supply. These openings also make the cervical vertebrae unique. As a result, proper alignment of the cervical spine plays a key role in the brain getting the blood and oxygen it needs to function properly.
Knowing these points about the function and design of the cervical vertebrae is an important factor in understanding the connection between the spine and migraines.
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What Causes Migraines In Females
Migraine is one of the leading serious health problems affecting women, impacting 18% of all women in the US. Of the more than 39 million American sufferers, 28 million are women.
Migraine in women is often associated with fluctuating hormone levels, which may help explain why they are more likely to suffer from migraine attacks than men. Womens estrogen levels vary throughout their lives, with increases during fertile years and decreases afterwards. In fact, WebMD reports that “many women find their migraines improve or disappear after age 50.”
Migraine Aura And Stroke
It has been shown that patients with migraine aura have a slightly increased risk of having a stroke. This is a small risk but can increase further if other risk factors are present such as smoking, high blood pressure, high cholesterol, and being over-weight. So, it is important that patients stop smoking, get their blood pressure, cholesterol and glucose levels checked regularly and maintain a healthy lifestyle and body weight. Another thing that can increase the chances of stroke in these patients is the use of the combined contraceptive pill: this should be avoided by female patients with migraine aura. There are other hormonal options available for contraception. It is important to note that use of oestrogen containing HRT is allowed in patients with migraine and aura.
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Most Common Aura Symptoms
Aura refers to a variety of visual, sensory, and speech disturbances that can occur with or without a headache. These usually last for 2060 minutes but can sometimes last for several days.
According to a review in the Journal of Headache and Pain, a person experiencing migraine with aura may notice the following symptoms:
- visual changes, such as seeing flashes of light, spots, or zigzag lines or experiencing a temporary loss of vision
- sensory changes, such as numbness or tingling in arms, legs, fingers, or face
- speech changes, such as difficulty finding words and garbled speech
- weakness or difficulty moving the arms, legs, or face
Throughout a persons life, both the number of times they experience migraine with aura and how they experience these episodes can change. A person may also notice that their symptoms of aura continue without accompanying headaches as they get older.
Many of the same factors that trigger migraine without aura can also cause migraine with aura. These potential causes include the following:
Migraine With Aura Prevention
If other treatments donât work and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You take these regularly to make migraines less strong or happen less often. These include seizure medicines, blood pressure medicines , and some antidepressants. A new class of preventive medicine called CGRP inhibitors may also help.
Your doctor can also prescribe a device, Cefaly, that uses a method called transcutaneous supraorbital nerve stimulation. You wear it as a headband on your forehead and turn it on daily for 20 minutes to prevent migraines.
Avoid your triggers. Common ones include:
- Certain foods
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When To Contact A Medical Professional
- You are experiencing “the worst headache of your life.”
- You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a migraine before.
- A headache starts suddenly.
Schedule an appointment or call your provider if:
- Your headache pattern or pain changes.
- Treatments that once worked no longer help.
- You have side effects from your medicine.
- You are taking birth control pills and have migraine headaches.
- Your headaches are more severe when lying down.
Updates On The Clinical Features Of Migraine Especially Migraine With Aura
Randolph W. Evans, MD
Although we see migraineurs almost daily and over 50 percent of us are migraineurs,1 a review of the clinical features may be of interest.
Migraine has a one-year period prevalence of 12 percent and2 some 35 million people annually have migraine in the United States. The cumulative incidence of migraine by age 85 is 18.5 percent in males and 44.3 percent in females with onset before the age of 25 in 50 percent of cases, in 75 percent before the age of 35 years, and only two percent over the age of 50.3 The median age of onset is 25 years. About 8 percent of boys and 11 percent of girls have migraine.4 Chronic migraine, with attacks occurring on 15 or more days per month for at least three months, occurs in about 3.2 million people per year in the United States, 80 percent women.5
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The Symptom Spectrum Of The Migraine Aura
Migraine, a partially genetic prevalent brain disorder , presents with attacks separated by interictal phases. An attack can be considered as a dysfunctional brain state probably related with long-lasting anatomical and functional consequences, as shown by our group and others .
In at least a third of migraine attacks, the headache phase is preceded and/or accompanied by transient neurological symptoms referred to as aura. In this case, the condition is classified as migraine with aura , contrary to migraine without aura , when no aura symptom is present . The most frequent aura phenotype consists of positive and/or negative visual phenomena, present in up to 99% of the patients . Phenotypes include primary visual disturbances, for example flashes of light, moving zigzags expanding in a horseshoe pattern, white spots, Ã¢like looking through air close to a road paved with asphalt in a very hot sunny dayÃ¢, colored spots; or less frequent more complex perceptions, such as fractured vision, dysmorphopsias, lilliputian or brobdingnagian hallucinations, misperceptions of distances, hemianopsias, tunnel vision, among others . Since visual auras varies in form, severity, and duration, the anatomical location, extent, and probably nature of the underlying occipital dysfunction must vary accordingly.
What Commonly Triggers A Migraine
People who get migraines may be able to identify triggers that seem to kick off the symptoms. Some possible triggers include the following:
- Stress and other emotions
- Biological and environmental conditions, such as hormonal shifts or exposure to light or smells
- Fatigue and changes in one’s sleep pattern
- Glaring or flickering lights
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Are Migraine Auras Serious
Migraine with aura is repeated episodes of headache that occur during or after sensory disturbances . These disturbances may include symptoms such as flashes of light, blind spots, and other vision changes or tingling over the hand or face. Migraine aura;is not in itself;dangerous; however,;the;symptoms of migraine aura can sometimes look and feel like other serious conditions such as a stroke. It is advisable to consult a doctor to rule out anything serious. Triggers and treatment of migraine with aura and migraine without aura are usually the same.
Migraine is a type of headache characterized by intense throbbing pain in the head or behind the eyes. Throbbing pain or pulsing sensation usually begins on one side of the head, in the forehead, or around the eyes. Headache is aggravated by sudden movement, physical activity, loud noise, or bright light. Migraine may occur once or twice a month or every day and is accompanied by symptoms such as nausea, vomiting, giddiness, or sensitivity to light and sound. Migraine pain normally lasts from 4 hours to 3 days and could be so severe that it may interfere with routine activities. The triggers, site of headache, severity, associated symptoms duration, and frequency of migraine episodes can vary from person to person. The symptoms of migraine aura also can vary from person to person. Migraines have a strong genetic predisposition and are usually more common in women than in men.